High Cholesterol in Children

Why is high cholesterol in children considered a problem?

Adults are not the only people affected by high cholesterol. Children also might have high levels of cholesterol, which can result in health concerns when the child gets older. Too much cholesterol leads to a build-up of a material, called plaque, on the walls of the arteries that supply blood to the heart and other organs. Plaque can narrow the arteries and block the blood flow to the heart, causing heart problems. Cholesterol also is related to other health problems including stroke.

What causes high cholesterol in children?

Cholesterol levels in children are linked to three factors: heredity, diet, and obesity. In most cases, kids with high cholesterol have a parent who also has elevated cholesterol.

How is high cholesterol in children diagnosed?

Healthcare professionals can check cholesterol in school-age children with a simple blood test. Conducting such a test is especially important if there is a strong family history of heart disease or if a parent of the child has high cholesterol. The blood test results will reveal whether a child's cholesterol is too high.

Updated guidelines and recommendations for the treatment of high cholesterol in children eight years of age and older were issued by the American Academy of Pediatrics in July 2008. These guidelines recommend:

• Medical treatment of elevated LDL (bad cholesterol) if the value is greater than 190 mg/dL in patients with no risk factors for cardiovascular disease and if diet modification has been unsuccessful.
• Medical treatment for patients with an LDL greater than 160 mg/dL who have a family history of an early onset of cardiovascular disease or other risk factors, including obesity, hypertension, or cigarette smoking.
• Medical treatment for patients with an LDL greater than 130 mg/dL who have diabetes.

How is high cholesterol in children treated?

The best way to treat cholesterol in children is with a diet and exercise program that involves the entire family. If changes in diet and exercise do not have the desired effect, medicine might be considered for children older than eight.

Some drugs used to treat cholesterol in children include cholestyramine, colestipol, and colesevelam. Recent studies in children with very high cholesterol have supported the safe use of drugs in the statin class. A child's cholesterol levels should be re-tested after three months of dietary changes and/or medicines.

How can I help lower my child's cholesterol?

The American Academy of Pediatrics currently recommends that children two years and older follow a healthy diet according to the current Dietary Guidelines for Americans. This should include low-fat dairy products. For children 12 months to two years of age who have overweight/obesity, or who have a family history of obesity, high cholesterol, or cardiovascular disease, the use of reduced-fat milk is recommended.

You can help lower your child's cholesterol levels by encouraging them to do the following:

• Eat foods low in total fat, saturated fat and cholesterol. The amount of fat a child consumes should be 30 percent or less of daily total calories (45 to 65 grams of fat or less per day). This suggestion does NOT apply to children under the age of two.
• The American Academy of Pediatrics currently recommends that children 2 years and older follow a healthy diet according to the current Dietary Guidelines for Americans. This should include low-fat dairy products. For children 12 months to two years of age who have overweight/obesity, or who have a family history of obesity, high cholesterol, or cardiovascular disease, the use of reduced-fat milk is recommended.
• Exercise regularly. Regular aerobic exercise – such as biking, running, walking, and swimming – can help raise HDL levels and lower your family's risk for cardiovascular disease.
• Maintain a weight that's healthy for them.
• Substitute unsaturated fat for saturated fat. Saturated fat is usually solid at room temperature and comes from animal fats, coconut, and palm oils. Unsaturated fat is liquid at room temperature and comes from plants. Olive oil, canola oil, and peanut oil are examples of unsaturated fat.

Select a variety of foods so your child can get all the nutrients they need. Children and adolescents at higher risk for cardiovascular disease with elevated LDL values above their target goals are advised to undergo nutritional counseling and take part in regular physical activity.

What are some examples of good foods?

• For breakfast: Fruit, cereal, oatmeal, and yogurt are among the good choices for breakfast foods. Use skim or low-fat milk rather than whole or 2 percent milk.
• For lunch and dinner: Bake or grill foods instead of frying them. Use whole-grain breads and rolls to make a healthier sandwich. Also, give your child whole-grain crackers with soups, chili, and stew. Prepare pasta, beans, rice, fish, skinless poultry, or other dishes. Always serve fresh fruit (with the skin) with meals.
• For snacks: Fruits, vegetables, breads, and cereals make great snacks for children. Children should avoid soda and fruit drinks.